Symptômes de sevrage tabagique

Cessation treatment based on controlling withdrawal symptoms assumes that individuals attempting to stop nicotine use are dependent on nicotine, and that the discomfort of withdrawal is a major issue in successful cessation.

Les symptômes de sevrage

En tant que professionnels de la santé, il est important d’identifier les symptômes de sevrage et de prévenir les patients de leur probable apparition lors du sevrage. Ces symptômes sont maximaux dans les premiers jours et se dissipent progressivement au bout d’un mois (Hughes 2007). Les symptômes de sevrage les plus courants sont :

  • Troubles de l’humeur
  • Insomnie
  • Irritabilité
  • Frustration, Colère
  • Anxiété
  • Difficulté de concentration
  • Augmentation de l’appétit
  • Fébrilité

Règle ‘Pas une taffe’

En soutenant une tentative d’abandon, il est important de souligner les difficultés probables, par exemple à propos des symptômes de sevrage. Cependant, l’une des choses les plus importantes à souligner pour les personnes qui ont récemment arrêté ou qui vont arrêter est la règle de « pas une taffe ».

Si un individu casse une règle auto-imposée, même une fois, il y a une tendance à abandonner l’objectif comportemental. Un nombre important de personnes qui cessent de fumer fumeront dans les premiers jours d’arrêt.

Ceux qui échouent une fois sont très peu susceptibles de se reprendre et de rester abstinents.

Bibliographie et autres lectures
Anderson CM, Zhu SH. Tobacco quitlines: looking back and looking ahead. Tobacco Control 2007;16 Suppl 1:i81–86.
Brandon TH, Collins BN, Juliano LM, Lazev AB. Preventing relapse among former smokers: A comparison of minimal interventions through telephone and mail. Journal of Consulting and Clinical Psychology 2000;68:103–13.
Brown RA, Lejuez CW, Kahler CW, Strong DR, Zvolensky MJ. Distress tolerance and early smoking lapse. Clinical psychology review. 2005 Sep 30;25(6):713-33.
Brunette MF, Ferron JC, Gottlieb J, Devitt T, Rotondi A. Development and usability testing of a web-based smoking cessation treatment for smokers with schizophrenia. Internet Interventions. 2016 May 31;4:113-9.
Chauhan P, Dev A, Desai S, Andhale V. Nicotine replacement therapy for smoking cessation. Pharmaceutical and Biological Evaluations. 2016 Jun 11;3(3):305-12.
Hajek P, Belcher M, Stapleton J. Enhancing the impact of groups: an evaluation of two group formats for smokers. British Journal of Clinical Psychology. 1985 Nov 1;24(4):289-94.
Hajek P. Nicotine chewing gum in the group treatment of smokers. InWorld Congress, Harvard University, Cambridge, Institute for the Study of Smoking Behaviour and Policy 1986.
Hajek P. Treatments for smokers. Addiction. 1994 Nov 1;89(11):1543-9.
Hajek P. Withdrawal‐oriented therapy for smokers. British journal of addiction. 1989 Jun 1;84(6):591-8.
Hall SM, Humfleet GL, Reus VI, Munoz RF, Cullen J. Extended nortipyline and psychological treatment for cigarette smoking. Am J Psychiatry. 2004;161(11):2100–2107.
Hughes JR, Gust SW, Skoog K, Keenan RM, Fenwick JW. Symptoms of tobacco withdrawal: a replication and extension. Archives of general psychiatry. 1991 Jan 1;48(1):52-9.
Hughes JR. Effects of abstinence from tobacco: etiology, animal models, epidemiology, and significance: a subjective review. Nicotine & Tobacco Research. 2007 Mar 1;9(3):329-39.
Lai DTC, Cahill K, Qin Y. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev. 2010;1:CD006936.
Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. The Cochrane Library. 2005 Jan 1.
McKee SA, Krishnan-Sarin S, Shi J, Mase T, O’Malley SS. Modeling the effect of alcohol on smoking lapse behavior. Psychopharmacology. 2006 Dec 1;189(2):201-10.
Pommerenke FA, Dietrich A: Improving and maintaining preventive services, Part 2: Practical principles for primary care. J Fam Pract. 1992, 34: 92-97.
Rigotti NA, Rennard SI, Daughton DM. Benefits and risks of smoking cessation. UpToDate. Waltham (MA): UpToDate; Available at: http://www. uptodate. com/contents/benefits-and-risks-of-smoking-cessation. 2013:1-50.
Roberts NJ, Kerr SM, Smith SM. Behavioral interventions associated with smoking cessation in the treatment of tobacco use. Health Services Insights. 2013;6:79.
Russell MA, Jarvis MJ. Theoretical background and clinical use of nicotine chewing gum. NIDA research monograph. 1984 Dec;53:110-30.
Schwarzer R. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology. 2008 Jan 1;57(1):1-29.
Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. The Cochrane database of systematic reviews. 2001 Dec(3):CD001007-.
Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2005 Apr 18;2(2).
Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. The Cochrane Library. 2006 Jul.
Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. The Cochrane Library. 2006 Jul.
Vangeli E, Stapleton J, West R. Smoking intentions and mood preceding lapse after completion of treatment to aid smoking cessation. Patient education and counseling. 2010 Nov 30;81(2):267-71.
West RJ, Hajek P, Belcher M. Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking. Psychological medicine. 1989 Nov 1;19(04):981-5.
West RJ, Hajek P, Belcher M. Time course of cigarette withdrawal symptoms during four weeks of treatment with nicotine chewing gum. Addictive behaviors. 1987 Dec 31;12(2):199-203.
West RJ, Hajek P, Belcher M. Which smokers report most relief from craving when using nicotine chewing gum?. Psychopharmacology. 1986 Jun 1;89(2):189-91.
Wu L, He Y, Jiang B, Zuo F, Liu Q, Zhang L, Zhou C. Additional follow-up telephone counselling and initial smoking relapse: a longitudinal, controlled study. BMJ open. 2016 Apr 1;6(4):e010795.
Zhu S, Anderson CM, Tedeschi GJ, et al. Evidence of real-world effectiveness of a telephone quitline for smokers. N Engl J Med. 2002;347:1087–1093.
Photos
Nicotine by Pablo Andres. Available at https://www.flickr.com/photos/pabloeivissa/6184106249/in/photolist-aqtakx-pNPvU-4tEZC7-pNPp1-ex51wP-pjVe9a-pNPh9-r48jfp-eDbYd1-aGfaVe-6LynGd-nzPJGo-4FzAy1-73ftv3-cVWMH3-7x3LSy-4mqAj-4xs3eB-9nbQmm-7qKFNn-9abURx-3tTCR-7fF98H-outau-69mU6h-5ojLyi-9af5xE-GJsFs-2bZHo-3YBW2E-a3ZmAm-26qEHN-x1ohv-7Whpjr-7hbTfG-niAYu-AJtiMB-qWsaXB-59dyLh-3eHxN-4wp51L-9a3C5G-6iwBW-au1L5S-3caTjw-bqvuxr-p1n4NV-qfTv4X-qbLe2S-ijBdaF Licensed under CC BY-NC-ND 2.0
Group by Stephen Downes. Available at https://www.flickr.com/photos/stephen_downes/506074326/in/photolist-LHLgq-fTwoz-arcecj-bq2QLM-H1kyS-2meeyh-4A27Tz-G6FoD9-HnuxC-jtiii-fREeL-jthMt-FAwnTX-bq2MLk-jti2M-8PYJjH-FyUo-jtitX-zuEuPM-dbk7U-tdE1m-jNmaQ-9M6uNQ-dABGVR-wKPZuX-7tiRJL-dAHbq9-qf2eoe-27Svp-pZTtRL-h6m1Zn-RCE3kh-fMRhu6-4U9bph-2VDvaD-64ewNJ-fKgDtT-7frcdX-2t8c1-nNN4xY-bJnqoR-4R1ka1-cbpWRC-38uNrj-8EbnMj-m5rFgr-6VucP1-HPM6Gx-4PwbCE-fKgLsc Licensed under CC BY-NC 2.0
Therapy by RandomDrps. Available at https://www.flickr.com/photos/randomdrps/8616632634/in/photolist-e8quFC-KuE9AU-RQKRXq-9S8DBr-SNZPA2-PGWpn7-4V9vZN-5pbza9-9hEpMo-AnBXE-aUPSda-aUPPS2-5ZYrGa-byrWDy-692vWi-TiXckh-7QAWJj-696H6J-byrWr7-bMmDoT-og2pB9-7QAWnQ-bMmCX2-8frSZ3-7QAX95-bMmD8M-68GvJt-4gTnCb-qhzNc9-jCTJ-byrWbq-qhN6yD-5expZL-rp45vi-sadp2B-Sc26ta-4gPipx-byrVXs-7QxBwD-7QSEE1-7QAWC1-bMmDER-692vWV-7QxBgK-4GZnek-76sKd-dPtwFX-3T1D4F-qX1i5s-co2yP5 Licensed under CC BY-NC 2.0

Le saviez-vous?

En France, environ 3 millions de personnes dans la population 15-75 ans utilisent des cigarettes électroniques et la moitié d’entre eux sont des utilisateurs quotidiens. Parmi eux, la majorité consomme également du tabac puisque 75% sont des fumeurs réguliers (source : Santé Publique France, INPES 2016).